Provider Demographics
NPI:1235313073
Name:ORSI, CARISSE M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARISSE
Middle Name:M
Last Name:ORSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARISSE
Other - Middle Name:A
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-257-1400
Mailing Address - Fax:210-450-4903
Practice Address - Street 1:5107 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4801
Practice Address - Country:US
Practice Address - Phone:210-614-8612
Practice Address - Fax:210-615-1666
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN52992080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210133901Medicaid
TX210133902OtherCSHCN
TX210133901Medicaid